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26th Jan, KINE 3350.docx

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Kinesiology & Health Science
KINE 3350
Kathy Broderick

Physiology of Aging - Changes  are inevitable, people change as they age 1. Genes  genes account for about 25% of longevity. People who are studying genes today realize that people who live to 100 carry genes that give them protection from things that kill other people. IF they identify these genes, they can increase the longevity of people 2. Lifestyle 3. Environment  age related changes will be more extreme if someone was malnourished or lived in a bad area when growing up - Disorders (Chronic Diseases) 80% of seniors who are +65 have at least 1 chronic disease. The big 2 are diabetes and high blood pressure. In terms of life expectancy, many people live the last 10 years of their life in morbidity (they live the last 10 years with a chronic disease). This is a huge healthcare cost; we spend $2 out of every $3 on healthcare for those with chronic diseases. We’ll spend $40 billion on people with chronic diseases while we only spend $8 billion on prevention. All chronic diseases can be managed with a proper plan. Many seniors these days don’t have the skills (eg. literacy skills to understand) to understand things so they aren’t as capable of managing their chronic diseases but the baby boomers should be able to. Medicine today is all about preventing and managing chronic diseases because medicines have already been created. Ontario Health Study looks at 18 year olds and up and is following people through their lifespan looking at many factors that affect each person. - Many baby boomers are overweight and unhealthy and they are in the prime age for heart disease. So in terms of the boomers is 60 the new 70? Are boomers going to be the first generations of Canadians to die before their parents because of their health conditions/stress? 1. Cardiovascular System  used to be the number one killer in Canada but now cancer is. 1 in 2 adults over 65 has some type of heart disease. Every 7 minutes someone has a heart attack or stroke and every 8 minutes someone dies from a heart attack. Now there are more women suffering from cardiovascular disease than men. 1. The Heart  the heart muscle gets bigger, the 4 valves in the heart calcify so the heart is inefficient at pumping through the blood. Pacemaker cells decrease in number so a lot of older people will have slight arrhythmias. The heart takes longer to recover (that’s why older people get tired fast). There is a decline in cardiac output. 2. The Veins  the veins expand so the blood moves slower to the vein, which contributes to the inefficiency of the heart. The blood can be susceptible to clotting because it moves slower 3. The Arteries  there is hardening of the arteries so they lose their elasticity and there are fatty deposits called plaque in the arteries. a) Risk Factors - Non-Control Factors 1. Aging 2. Male Gender  this is being more disputed because women after menopause are more at risk 3. Family History  you are at a higher risk if someone in your family has had a heart attack 4. Ethnicity  immigrants come to Canada with healthy hearts and they may not have family doctors in Canada/their diet changes/they have a more stressful lifestyle so they have a tendency to develop heart diseases. South Asians have a tendency to get heart disease 10 years younger than anyone else. The lowest rate of heart disease is in the Chinese. - Control Factors 1. Smoking  you can quit smoking 2. Obesity  a person’s girth is the best indicator of heart disease 3. Diabetes 4. High Cholesterol  control factor to a certain extent because some bodies just produce lots of bad cholesterol 5. Diet  our diets have too many trans-fats 6. Hypertension  your heart is working too hard so you are more at risk for heart attack 7. Inactivity 8. Personality Type  they used to say Type As have heart problems and generally men. People who are inherently angry are also at a higher risk 9. Emotional Stress  there are hormones released that affect the immune system and it increase the heart rate 10. Depression 11. Loneliness 12. Poverty  people who are poor; women, new immigrants, etc. maybe don’t change their habits because it is too expensive to eat healthy 13. Pollution  6 000 deaths in Toronto are due to pollution 14. Noise  increases levels of stress hormones and increases risk of heart disease - Diagnostic Modalities for Coronary Heart Disease - Cholesterol  some people’s bodies manufacture bad cholesterol but after the age of 40 people should get their cholesterol checked every year. 9/10 when your cholesterol is bad, the doctor will put you on a diet. Cardiologists says that they can’t wait and see if a diet will help fix the cholesterol problem and they think that you should be put on medications to decrease cholesterol immediately. Others disagree. - Electrocardiogram  if you are over 40, you should have these at every physical. These look at the pattern of the heart. From the ECG you can tell if the heart rhythm is normal and if it is getting enough oxygen. It can also tell you if you had a heart attack. -They put electrodes on your arms and legs. - Exercise Stress Test  recommended for older people. Heart’s reaction to physical activity. You are put on a bike or treadmill and your blood pressure is monitored. This can show how your heart is functioning relevant to activity. - Thallium Cardiolite Scan  radioactive substance (dye) is put into your bloodstream and you basically do an exercise stress test. They can see how much of the substance is reaching the heart and if there are blockages. You repeat the test 4 hours later. This is good for when they think there is a blockage - Echocardiogram  ultrasound of the heart. They can take pictures and see if the heart is enlarged and how the valves are working. - Transesophageal Echo Cardiogram  (make you swallow camera) it goes down throat when the valves don’t look like they’re operating properly in an echocardiogram because the camera gets a better picture of what’s happening with the valves - Angiogram  catheter is sent up through the groin to the heart and dye is injected so you can see if there are any blockages and if the valves and things are working properly. **Technology has continued to improved and soon there will be no need for angiograms because there will be electronic imaging available. - Treatment for Coronary Artery Disease - Medication  least invasive. Most simplistic is aspirin, which will thin the blood to prevent clotting. You can be put on beta-blockers to slow the heart. Statins will be given for high cholesterol and there will be pills for hypertension. They’re developing a “poly-pill” so all these medications will be in one pill (will be good with complacency because some old people don’t like taking their medications). - Angioplasty  if they think you have blocked arteries or a heart attack they will do an angioplasty. A catheter is sent up the grown to the heart and there is a balloon that is inflated to remove a blockage in an artery. It is 90% effective and cuts the risk of people having heart attacks. Unfortunately many people are back within 6 months because they don’t change their lifestyle. - Coronary Stents  if the angioplasty doesn’t do the job in terms of opening up the arteries or particularly in the neck area they will send metal stents up that will hold the artery open for the rest of your life - Coronary Bypass  if you’ve had a heart attack (because of a blocked artery) they will do a coronary bypass and it is very invasive. A vein is taken from your leg and the blocked area is rerouted using the leg vein. **It takes about a year for someone to fully recover from their surgery. They found a third of people stopped taking their medications within the year. Also a lot of people just never even fill their prescription because they don’t feel like it or the medications are too expensive c) Hypertension - Blood Pressure  120/80 to 139/89 is called pre-hypertension. These people should consider themselves to have high blood pressure 140/90 or above is hyper tension -30 Canadians die today due to too much salt intake. - Risk Factors  major risk factor is salt intake. This has been recognized in the past 5 years that as one ages, the body has less of an ability to deal with sodium and it raises blood pressure. Because of too much salt, the heart also retains fluid and has to pump harder. One out of 8 cardio-events are due to too much salt. Canadians are the highest consumers of salt in the world. All our products have more salt in them (eg. Kellogg’s or Burger King in Canada). The quota of salt per day should be one piece of pizza. The Canadian Medical Society is going to start a war on salt and suggests that Canadians should only have one teaspoon of salt or 5 g of salt a day. White coat syndrome: blood pressure goes up Everyone should do it , it helps you regularly check up - Prevalence  more prevalent today than it was 5 years ago. There are more people on medications for high blood pressure. Hypertension has no symptoms and unless you get it tested you really don’t know. - Treatment  diet advocated is the DASH diet, which stands for Dietary Approaches to Stop Hypertension. The DASH diet is very good, doctors will recommend it (usual healthy di
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